尤瑞克林对急性脑梗死后细胞凋亡相关因子表达的影响及其作用机制的探讨

发布时间：2018-01-31 01:05

本文关键词： 尤瑞克林急性脑梗死细胞凋亡 B淋巴细胞瘤-2蛋白细胞色素C　出处：《河北医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:急性脑梗死是导致人类死亡和致残的主要原因之一,其高发病率和高复发率对人们的健康和生活产生了严重的影响。目前很多学者认为抑制神经细胞凋亡从而改善神经功能缺失是治疗急性脑梗死的重要目标,本实验旨在研究尤瑞克林对急性脑梗死后细胞凋亡相关因子的影响及其作用机制的探讨。在实验中利用NIHSS评分观察对比用药前后患者神经功能改善的程度,并通过检测患者血清中B淋巴细胞瘤-2(Bcl-2)蛋白、细胞色素C(Cyt C)浓度的变化,探究尤瑞克林应用前后关于神经细胞凋亡的情况,以及进一步探讨尤瑞克林对急性脑梗死后细胞凋亡抑制作用的可能机制。方法:收集2015年1月至2015年10月期间就诊于河北医科大学第二医院神经内科的首次发病的急性脑梗死患者100例,将其随机分为尤瑞克林组和常规治疗组。以入院当天为起始,分别在第1天、14天和3个月时对两组患者进行NIHSS评分,并留取空腹静脉血5ml,在分离上层血清后,用酶联免疫吸附法(ELISA)检测血清中Bcl-2蛋白、Cyt C的含量。结果:1一般资料:本实验共纳入了100例急性脑梗死患者,均符合纳入标准,两组患者在年龄、性别、文化程度等方面均无统计学差异(P0.05),具有可比性。但由于个别患者病情加重及依从性差等原因,共22例患者在实验第14天前脱组,以至于在住院期间能按预计进行实验的患者包括尤瑞克林组45例,常规治疗组33例,两组入院时NIHSS评分无统计学差异(P0.05)。2临床疗效评价:两组患者在入院时NIHSS评分无统计学差异(P0.05),在14天及3个月时均较入院时有所下降,前后相比均有统计学差异(P0.05)。与常规治疗组相比,尤瑞克林组的临床疗效更明显,并且有统计学差异(P0.05)。3血清Bcl-2蛋白含量的测定:入院时两组患者血清Bcl-2蛋白含量无统计学差异(P0.05),随着时间的变化,尤瑞克林组中患者血清中Bcl-2含量先上升后下降,前后相比均有统计学差异(P0.05)。常规治疗组中患者Bcl-2蛋白含量一直下降,前后相比均无统计学差异(P0.05)。在第14天时两组相比有统计学差异(P0.05),3个月时两组相比有统计学差异(P0.05)。4血清Cyt C含量的测定:入院时两组患者血清中Cyt C含量无统计学差异(P0.05)。随着时间的变化,尤瑞克林组中患者血清中Cyt C含量先下降后上升,前后相比均有统计学差异(P0.05)。常规治疗组中患者Cyt C含量先上升后下降,前后相比均无统计学差异(P0.05)。在第14天时两组相比有统计学差异(P0.05),3个月时两组相比无统计学差异(P0.05)。结论:1尤瑞克林可以明显减轻急性脑梗死患者的神经功能缺失症状,且在3个月时仍有明显作用。2尤瑞克林可以通过抑制神经细胞凋亡而改善神经功能。3通过调节Bcl-2蛋白表达、减少线粒体中Cyt C释放到细胞质中,从而抑制半胱天冬酶(caspase)级联反应,可能是尤瑞克林抑制细胞凋亡的重要作用机制之一。
[Abstract]:Objective: acute cerebral infarction is one of the main causes of human death and disability. Its high incidence and high recurrence rate have a serious impact on people's health and life. At present, many scholars think that inhibition of neuronal apoptosis and improvement of neural function is an important goal in the treatment of acute cerebral infarction. The purpose of this study was to investigate the effect of eurexine on apoptosis related factors after acute cerebral infarction and its mechanism. To observe and compare the course of nerve function improvement before and after treatment with NIHSS score in the experiment. Degree. The changes of serum B lymphocytoma Bcl-2) protein and cytochrome C (Cyt C) concentration were detected to explore the apoptosis of nerve cells before and after eurekline application. To explore the possible mechanism of eurexine on the inhibition of apoptosis after acute cerebral infarction. Methods:. From January 2015 to October 2015, 100 patients with acute cerebral infarction (ACI) who were first diagnosed in the Department of Neurology, second Hospital of Hebei Medical University were collected. The patients were randomly divided into two groups: eurexine group and routine treatment group. The patients in the two groups were assessed with NIHSS on day 1, day 14 and month 3, respectively, and the fasting venous blood was kept at 5 ml. The Bcl-2 protein in serum was detected by enzyme linked immunosorbent assay (Elisa) after isolation of the upper serum. Cyt C content. Results: one hundred patients with acute cerebral infarction were included in this study, all of whom were in accordance with the inclusion criteria. The two groups of patients were in age and sex. There was no significant difference in education level between two groups (P 0.05), which was comparable. However, due to the aggravation and poor compliance of individual patients, a total of 22 patients were removed from the group before the 14th day of the experiment. The patients who were able to conduct the trials as expected during hospitalization included 45 patients in the Urekline group and 33 in the routine treatment group. There was no significant difference in NIHSS scores between the two groups at admission (P 0.05). There was no significant difference in NIHSS scores between the two groups at admission (P 0.05). After 14 days and 3 months compared with the admission, there was a statistical difference between the two groups (P 0.05). Compared with the routine treatment group, the clinical effect of Urikline group was more obvious. And there was a statistical difference in serum Bcl-2 protein content: there was no significant difference in serum Bcl-2 protein content between the two groups on admission (P0.05). With the change of time, the serum Bcl-2 content in eurekline group increased first and then decreased. There was significant difference between the two groups (P 0.05). The content of Bcl-2 protein in the routine treatment group had been decreasing. There was no statistical difference between the two groups before and after, and there was a statistical difference between the two groups on the 14th day (P0.05). Measurement of serum Cyt C levels in two groups at 3 months after admission: there was no significant difference in Cyt C levels between the two groups at admission (P 0.05). Over time. The level of serum Cyt C in Urekline group decreased first and then increased, and there was statistical difference between before and after. The Cyt C content of patients in routine treatment group increased first and then decreased. There was no statistical difference between the two groups before and after, and there was a statistical difference between the two groups on the 14th day (P0.05). There was no statistical difference between the two groups at 3 months. Conclusion: 1 / 1 eucrine can significantly alleviate the neurological deficit symptoms in patients with acute cerebral infarction. At 3 months, Eucrine could improve the neural function by inhibiting neuronal apoptosis and regulating the expression of Bcl-2 protein. Reducing the release of Cyt C from mitochondria into the cytoplasm, thus inhibiting the cascade of cysteinase caspase, may be one of the important mechanisms by which eucrine inhibits cell apoptosis.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R743.3

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